<div class="one">
  <span class="name"><b>About Yourself</b></span> <br> <br>
  <div class="border">
  <form action="/php/get_survey.php" method="post">
    <div class="three">
      <span> Enter the Email </span>  
      <input type="text" name="email">
         {%message%}
      <input class="up" type="submit" value="Sign Up">
    </div>
  </form>
</div>
